September 2015 Briefing - Geriatrics

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Here are what the editors at HealthDay consider to be the most important developments in Geriatrics for September 2015. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Calcium Supplements May Not Benefit Bone Health

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Extra calcium may not protect aging bones after all. The findings appear online in two reviews published online Sept. 29 in The BMJ.

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Nocturnal Hypoglycemia Linked to Reduced Awakening Response

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Nocturnal hypoglycemia is associated with reduced awakening response, according to a study published online Sept. 25 in Diabetes Care.

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Adjuvant Aripiprazole Beneficial in Tx-Resistant Depression

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Adjuvant aripiprazole is associated with achievement of remission among older adults with treatment-resistant depression, according to a study published online Sept. 27 in The Lancet.

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Angioedema Induced by New Classes of Drugs

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Two newer classes of drugs, dipeptidyl peptidase IV (DPP IV) and neprilysin inhibitors, can induce angioedema, according to research published in the October issue of Allergy.

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Negative Spiritual Belief Linked to Worse Health Outcomes

WEDNESDAY, Sept. 30, 2015 (HealthDay News) -- Any degree of negative spiritual belief is associated with worse health outcomes, regardless of positive spiritual beliefs, according to a study published in the Journal of Spirituality in Mental Health.

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Medical Costs Increasing for Smokers Who Develop PAD

TUESDAY, Sept. 29, 2015 (HealthDay News) -- Smoking significantly increases medical costs among patients with peripheral artery disease (PAD), a new study suggests. The findings were published in the Oct. 6 issue of the Journal of the American College of Cardiology.

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Moderate, More Severe Hearing Impairment Linked to Mortality

FRIDAY, Sept. 25, 2015 (HealthDay News) -- For older adults with hearing impairment (HI), moderate or more severe impairment is associated with mortality in an age-adjusted model, according to a research letter published online Sept. 24 in JAMA Otolaryngology-Head & Neck Surgery.

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Sleep Quality Improved in Seniors With Access to Natural Spaces

FRIDAY, Sept. 25, 2015 (HealthDay News) -- Seniors and men sleep more soundly if they have access to natural surroundings, such as beaches or parks, according to a study published in the September issue of Preventive Medicine.

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Orthostatic Hypotension Could Signal Neurological Disease

THURSDAY, Sept. 24, 2015 (HealthDay News) -- Orthostatic hypotension (OH) may be an early warning sign of a serious neurological disease and an increased risk of premature death, according to research published online Sept. 23 in Neurology.

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Saxagliptin Not Linked to Increased Fracture Risk in T2DM

THURSDAY, Sept. 24, 2015 (HealthDay News) -- For patients with type 2 diabetes, treatment with saxagliptin is not associated with increased fracture risk, according to a study published online Sept. 10 in Diabetes Care.

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Not All Trans Fats Appear to Be Created Equal for Heart Risk

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- A new study suggests that not all trans fats are equal, and some might even be beneficial. The findings were published online Sept. 22 in the European Heart Journal.

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Health Insurance Deductibles Rising Faster Than Wages

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- Health insurance deductibles have risen more than six times faster than American workers' average wages since 2010, a Kaiser Family Foundation report says.

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ICU for Pneumonia in Elderly Ups Survival, Not Costs

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- Admitting older, low-risk patients with pneumonia to the intensive care unit (ICU) -- compared with admission to regular wards -- is linked with higher survival rates but not higher medical expenses, new research suggests. The study was published in the Sept. 22/29 issue of the Journal of the American Medical Association.

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Mediterranean Diet May Protect Against Diabetic Retinopathy

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- The Mediterranean diet (MedDiet) may protect against diabetic retinopathy, according to a study published online Sept. 13 in Diabetes Care.

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Combo Drug May Calm Agitation in Alzheimer's Patients

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- A drug that combines dextromethorphan with quinidine might offer a safer option for calming the agitation that commonly affects people with Alzheimer's disease, researchers report in the Sept. 22/29 issue of the Journal of the American Medical Association.

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IOM: Most U.S. Patients Will Experience Diagnostic Error

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- A new report commissioned by the U.S. government contends that most Americans will encounter at least one diagnostic error in their lifetime, sometimes with severe consequences for their physical and mental health.

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Medical Schools Teaching Students About Costs of Care

TUESDAY, Sept. 22, 2015 (HealthDay News) -- Many medical schools are integrating discussions of cost, value, and effectiveness into their curricula, according to Kaiser Health News.

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Radiation Tx Impact Varies With Comorbidity in Prostate Cancer

TUESDAY, Sept. 22, 2015 (HealthDay News) -- For men with unfavorable-risk prostate cancer, the impact of radiotherapy (RT) versus RT plus androgen deprivation therapy (ADT) varies with comorbidity, according to a research letter published in the Sept. 22/29 issue of the Journal of the American Medical Association.

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DNR Orders After In-Hospital Cardiac Arrest Tied to Survival

TUESDAY, Sept. 22, 2015 (HealthDay News) -- For patients who receive successful resuscitation from in-hospital cardiac arrest, do-not-resuscitate (DNR) orders are generally associated with likelihood of favorable neurological survival, according to a study published in the Sept. 22/29 issue of the Journal of the American Medical Association.

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Sexual Activity Doesn't Seem to Trigger Repeat MI Events

TUESDAY, Sept. 22, 2015 (HealthDay News) -- Many myocardial infarction (MI) survivors are concerned that too much physical activity could trigger a repeat event. But after reviewing data collected on 536 heart disease patients between the ages of 30 and 70, researchers found sexual activity requires about the same amount of exertion as climbing two flights of stairs or taking a brisk walk. The research letter was published in the Sept. 29 issue of the Journal of the American College of Cardiology.

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Harms From Unnecessary Abx Extend Beyond Resistance

TUESDAY, Sept. 22, 2015 (HealthDay News) -- Use of antibiotics in patients with heart failure exacerbation in the absence of compelling evidence of infection is unnecessary and potentially harmful, according to teachable moment piece published online Sept. 21 in JAMA Internal Medicine.

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Docs in Productivity Models Likely to Encounter Compensation Caps

MONDAY, Sept. 21, 2015 (HealthDay News) -- Physicians, especially those working in a productivity model, need to understand compensation caps, which are set at a specific percentile of national pay based on surveys, according to a report in Medical Economics.

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Medicaid, Non-Home Discharge Tied to Longer Hospital Stays

MONDAY, Sept. 21, 2015 (HealthDay News) -- Prolonged hospital length of stay (LOS) is more likely among patients who are Medicaid enrollees with complex hospital stays who were not discharged home, according to a study published in the September issue of the Journal of Hospital Medicine.

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Volunteer Doctors Need to Check Liability Coverage

FRIDAY, Sept. 18, 2015 (HealthDay News) -- Physicians who volunteer their medical expertise should consider their legal risks, according to an article published online Sept. 3 in Medical Economics.

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Tai Chi Aids Physical Performance in Chronic Conditions

FRIDAY, Sept. 18, 2015 (HealthDay News) -- Tai chi has a favorable effect on physical performance in four chronic conditions, according to a review and meta-analysis published online Sept. 17 in the British Journal of Sports Medicine.

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2012 Office Visits 57% Higher for Women than Men, Ages 1864

FRIDAY, Sept. 18, 2015 (HealthDay News) -- In 2012 there were an estimated 301 physician office visits per 100 persons, with higher rates for females and adults aged 65 years and older, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Mid-Morning May Be Best Time for Workday Break

FRIDAY, Sept. 18, 2015 (HealthDay News) -- Choosing preferred activities for a work break and taking a break earlier in the shift are linked to more resource recovery after a break, according to a study published online Aug. 10 in the Journal of Applied Psychology.

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CDC Resource Set to Improve Nursing Home Antibiotic Use

FRIDAY, Sept. 18, 2015 (HealthDay News) -- The U.S. Centers for Disease Control and Prevention has released a new resource: Core Elements of Antibiotic Stewardship for Nursing Homes, which has been developed to guide improvement in antibiotic prescribing practices in nursing homes.

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PCPs Report Mixed Feelings About Recent Health Care Changes

THURSDAY, Sept. 17, 2015 (HealthDay News) -- Primary care providers have mixed feelings about recent changes in health care, according to a study published by the Commonwealth Fund and the Kaiser Family Foundation.

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Complex Chronic Diseases Appear to Drive Frequent Admissions

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Patients who are frequently admitted to U.S. academic medical centers are significantly more likely than other patients to have multiple complex chronic conditions, according to a study published in the September issue of the Journal of Hospital Medicine.

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Oncology Care Often Received at Multiple Hospitals

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Many patients receive surgical and medical oncology care from different hospitals, which is associated with higher costs, according to a study published in the Sept. 15 issue of Cancer.

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Hospitalized Patients With CKD Often Unaware of It

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Hospitalized patients with chronic kidney disease (CKD) frequently are unaware of their condition, according to research published in the September issue of the Journal of Hospital Medicine.

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Tai Chi Improves BP Control, Quality of Life in Older Adults

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Tai chi is effective in managing several hypertension-related risk factors in older adults, according to a study published in the October issue of The American Journal of Cardiology.

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Exercise Counters Fatigue-Related Mood Decline in Arthritis

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Physical activity counters the negative effect that fatigue can have on positive mood among adults with arthritis, according to a study published in the September issue of Arthritis Care & Research.

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Women Less Likely to Be Full Professors Than Men

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- In academic medicine, women are less likely to be full professors than men and have less startup funding than men, according to two studies published in the Sept. 15 issue of JAMA.

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Mortality Risk Up for Hip Surgery After Fracture Vs Elective THR

TUESDAY, Sept. 15, 2015 (HealthDay News) -- Patients undergoing surgery for hip fracture have a higher risk of mortality and major complications than those receiving an elective total hip replacement, according to research published online Sept. 15 in JAMA.

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USPSTF Recommendations for Aspirin Use Vary by Age

TUESDAY, Sept. 15, 2015 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has concluded that the benefits and harms of low-dose aspirin for prevention of cardiovascular disease (CVD) and cancer vary by patient age. These findings form the basis of a draft recommendation statement published online Sept. 14 by the USPSTF.

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Characteristics ID'd for Those Who Voluntarily Stop Eating

TUESDAY, Sept. 15, 2015 (HealthDay News) -- Most patients who hasten death by voluntarily stopping eating and drinking (VSED) are in poor health, and family physicians are often involved in the process, according to a study published in the September/October issue of the Annals of Family Medicine.

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Low HDL-C, High CRP Ups Mortality for Patients With CAD

TUESDAY, Sept. 15, 2015 (HealthDay News) -- For patients with coronary artery disease (CAD) on statin therapy after undergoing a first percutaneous coronary intervention (PCI), the risk of all-cause mortality is increased with low high-density lipoprotein cholesterol (HDL-C) levels and elevated C-reactive protein (CRP), according to a study published in the Oct. 1 issue of The American Journal of Cardiology.

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CDC Develops State-Level Chronic Disease Cost Calculator

TUESDAY, Sept. 15, 2015 (HealthDay News) -- A chronic disease cost calculator (CDCC) has been developed to estimate state-level costs, according to a study published online Sept. 3 in Preventing Chronic Disease.

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Low Vitamin D Status Linked to Accelerated Cognitive Decline

MONDAY, Sept. 14, 2015 (HealthDay News) -- For ethnically diverse older adults, low vitamin D status is associated with accelerated decline in cognitive function, according to a study published online Sept. 14 in JAMA Neurology.

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Mediterranean Diet With Olive Oil Cuts Breast Cancer Risk

MONDAY, Sept. 14, 2015 (HealthDay News) -- A Mediterranean diet supplemented with extra-virgin olive oil may reduce the risk of breast cancer, according to a study published online Sept. 14 in JAMA Internal Medicine.

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NIH: Benefits for More Intensive Control of Hypertension

MONDAY, Sept. 14, 2015 (HealthDay News) -- Clinicians should control hypertension much more aggressively than current guidelines suggest, to best reduce the risk of heart attack and stroke in people 50 or older. That's the message behind the potentially game-changing results of a U.S. National Institutes of Health study released Friday.

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Anticoagulation Report Has Little Impact in Discharge Summary

MONDAY, Sept. 14, 2015 (HealthDay News) -- For patients on warfarin, an anticoagulation report that is embedded in the discharge summary has no impact on clinical outcomes, although it is perceived to improve patient safety, according to a study published in the September issue of the Journal of Hospital Medicine.

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California State Assembly Approves Right-to-Die Bill

FRIDAY, Sept. 11, 2015 (HealthDay News) -- The California State Assembly approved a bill on Wednesday that would allow doctors to prescribe life-ending medications to patients expected to die within six months.

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For Pharma Reps, Access to Physicians Continuing to Drop

FRIDAY, Sept. 11, 2015 (HealthDay News) -- Physician access for pharmaceutical representatives is continuing to decline, with access restricted to some degree for more than half of physicians, according to an AccessMonitor survey published by ZS.

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CDC: Second Death Reported in Salmonella Outbreak

THURSDAY, Sept. 10, 2015 (HealthDay News) -- A second death has been reported in a Salmonella outbreak that has been linked to contaminated cucumbers and caused 341 illnesses in 30 states, U.S. health officials said Wednesday.

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Physician Re-Entry Program Set to Redress Physician Shortage

THURSDAY, Sept. 10, 2015 (HealthDay News) -- An online educational program aims to help physicians get back to work and reduce the nation's physician shortage, according to an article published by the American Academy of Family Physicians (AAFP).

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4% Increase in Population of Actively Licensed Physicians

THURSDAY, Sept. 10, 2015 (HealthDay News) -- The total population of actively licensed physicians in the United States and the District of Columbia has increased by 4 percent since 2012, according to a report published in the Journal of Medical Regulation.

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Unlicensed Stem Cell Clinics Operating in the United States

THURSDAY, Sept. 10, 2015 (HealthDay News) -- Hundreds of clinics across the United States are offering unapproved stem cell treatments for conditions from hair loss to heart failure and Alzheimer's disease, researchers report in the Sept. 10 issue of the New England Journal of Medicine.

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Post-Op Delirium Diminishes Recovery in Older Patients

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Patients with delirium following major surgery are more likely to have worse outcomes, including lower quality of life, disability, or even death, according to a study published online Sept. 9 in JAMA Surgery.

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Management, Treatment of Chronic Disease Up With ACA

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- More Americans are getting health insurance as a result of the Affordable Care Act, which may lead to many more people getting diagnosed and treated for chronic conditions, such as diabetes, a new study contends. The findings were published in the September issue of Health Affairs.

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Over Half of U.S. Adults Have Diabetes or Prediabetes

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- More than half of all American adults have type 2 diabetes or prediabetes, according to a new report published in the Sept. 8 issue of the Journal of the American Medical Association.

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Accelerated MD Program Doesn't Mar Academic Performance

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- An accelerated baccalaureate (BA)/doctor of medicine (MD) program does not impair the academic performance of medical students, according to a study published online July 3 in Academic Medicine.

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EHR Vendors Not Adhering to Usability Certification Standards

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Among electronic health record (EHR) products, there is a lack of adherence to the U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) standards, according to a research letter published in the Sept. 8 issue of the Journal of the American Medical Association.

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ACP Supports Expanded Role of Telemedicine for Health Care

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Telemedicine can be beneficial, within the framework of an established physician-patient relationship, according to a position paper published online Sept. 8 in the Annals of Internal Medicine.

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Non-O Blood Group Tied to Higher CAD, MI Risk

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Having non-O blood group may be an independent risk factor for coronary artery disease (CAD) and myocardial infarction, according to a meta-analysis published in the Sept. 1 issue of The American Journal of Cardiology.

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Life Expectancy Increases Seen Worldwide

FRIDAY, Sept. 4, 2015 (HealthDay News) -- Average life expectancy among people worldwide has risen by more than six years since 1990, and healthy life expectancy has climbed by more than five years, according to a new report published online Aug. 27 in The Lancet.

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Social Distress ID'd in Minority of Colorectal Cancer Survivors

FRIDAY, Sept. 4, 2015 (HealthDay News) -- A minority of colorectal cancer (CRC) survivors experience social distress (SD), and having multiple long-term conditions is the strongest predictor, according to a study published online Aug. 17 in the Journal of Clinical Oncology.

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Suggested Response Provided for In-Flight Medical Emergencies

FRIDAY, Sept. 4, 2015 (HealthDay News) -- In a review article published online Sept. 3 in the New England Journal of Medicine, guidance is offered for physicians providing emergency in-flight medical care.

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Sustained Calorie Restriction May Help Prevent Age-Related Disease

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Sustained calorie restriction can influence disease risk factors and possible predictors of longevity in healthy, non-obese people, according to a study published in the September issue of the Journal of Gerontology: Medical Sciences.

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Bike Injuries Up Among Older Americans

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Injuries among older bicyclists have increased dramatically in recent years, according to a research letter published in the Sept. 1 issue of the Journal of the American Medical Association.

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Fewer Repeat Hemorrhagic Strokes With Better BP Control

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Survivors of intracerebral hemorrhage may be at higher risk for recurrence if their blood pressure (BP) isn't under control, a new study warns. The findings were published in the Sept. 1 issue of the Journal of the American Medical Association.

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Older Cancer Patients Heavily Use Health Care Services

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Older patients with acute myeloid leukemia (AML) are intense users of health care services and rarely use palliative care and hospice services, according to a study published in the August issue of Cancer.

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Cardiovascular Risk Up After Knee, Hip Replacement

WEDNESDAY, Sept. 2, 2015 (HealthDay News) -- Patients who have total hip or knee replacement surgery face a greater risk for myocardial infarction (MI) during the first month following the procedure, according to research published online Aug. 31 in Arthritis & Rheumatology.

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Resting Heart Rate, HR Variability May Help ID Functional Disability

TUESDAY, Sept. 1, 2015 (HealthDay News) -- Seniors with a higher resting heart rate and lower heart rate variability are less able to care for themselves, according to a study published online Aug. 31 in CMAJ, the journal of the Canadian Medical Association.

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Critical Care Docs Rarely Discuss Religion With Patients, Families

TUESDAY, Sept. 1, 2015 (HealthDay News) -- Religion or spirituality is important to many people nearing the end of life, but intensive care clinicians rarely talk to patients or their families about those beliefs, according to a study published online Aug. 31 in JAMA Internal Medicine.

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Observation Stays Can Exceed Cost of Inpatient Deductible

TUESDAY, Sept. 1, 2015 (HealthDay News) -- More than one-quarter of Medicare beneficiaries with multiple observation stays have a cumulative financial liability that exceeds that of the inpatient deductible, according to a study published online Aug. 20 in the Journal of Hospital Medicine.

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Endoscopic Evaluation Advised in Non-Hodgkin's Lymphoma

TUESDAY, Sept. 1, 2015 (HealthDay News) -- For elderly adults diagnosed with non-Hodgkin's lymphoma, endoscopic evaluation may be recommended even in the absence of gastrointestinal symptoms, according to a letter to the editor published in the August issue of the Journal of the American Geriatrics Society.

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